Provider: Ingenta Connect
Database: Ingenta Connect
Content: application/x-research-info-systems
TY - ABST
AU - Law, Fergus D.
AU - Myles, Judy S.
AU - Daglish, Mark R. C.
AU - Nutt, David J.
TI - The clinical use of buprenorphine in opiate addiction: evidence and practice
JO - Acta Neuropsychiatrica
PY - 2004-10-01T00:00:00///
VL - 16
IS - 5
SP - 246
EP - 274
KW - detoxification
KW - Subutex
KW - partial μ
KW - -opioid receptor agonist
KW - α
KW - -2 adrenergic agonists
KW - maintenance
KW - opiates
KW - clinical
KW - Buprenorphine
KW - treatment
KW - methadone
N2 - Law FD, Myles JS, Daglish MRC, Nutt DJ. The clinical use of buprenorphine in opiate addiction: evidence and practice. Buprenorphine is a partial μ-opioid receptor agonist that is being increasingly used in clinical practice in the treatment of opioid dependence in the UK, USA, and, elsewhere. Its unique pharmacological properties mean it is a relatively safe drug, it can be given by alternate day dispensing, and it is associated with relatively mild symptoms on withdrawal. The interpretation of the research literature on buprenorphine is however, complex, and often appears to be in conflict with how buprenorphine is used in clinical practice. This article describes these apparent contradictions, their likely explanations, and how these may further inform our clinical practice. The article also describes the clinically relevant pharmacological properties of buprenorphine, compares it to methadone, relates the evidence to clinical experience, and provides practical advice on how to manage the most common clinical techniques. The best quality evidence suggests that very rapid buprenorphine induction is not associated with a higher drop-out rate than methadone, that buprenorphine is probably as good as methadone for maintenance treatment, and is superior to methadone and α-2 adrenergic agonists for detoxification. However, buprenorphine cannot yet be considered the ‘gold standard’ treatment for opiate dependence because of the higher drop-out rates that may occur on induction using current techniques, its high-cost relative to methadone, and because the place of buprenorphine in treatment is still continuing to evolve.
UR - http://www.ingentaconnect.com/content/mksg/acn/2004/00000016/00000005/art00004
M3 - doi:10.1111/j.0924-2708.2004.00095.x
UR - https://doi.org/10.1111/j.0924-2708.2004.00095.x
ER -